A healthy life may require a good start

Originally published September 16, 2012 at 7:10 pm

Updated September 16, 2012 at 9:16 pm

Early-life stress and trauma can harm American lives. Columnist Jerry Large says a new book convinced him that the country has to do more to help people when they are young, because stresses and traumas manifest in mental and physical ways later on.

We know that the U.S. outspends other countries on health care but lags behind on measures of good health. We know something is wrong.

Over the past few years, research has spotlighted a big part of the problem. We’re subjecting our babies and children to psychological damage that causes chemical and structural changes that affect mental and physical health throughout life.

I’ve been reading a new book about that. It’s titled “Scared Sick: The role of Childhood Trauma in Adult Disease,” and it’s written by Robin Karr-Morse and Meredith Wiley. In our youngest children, society sows the seeds of problems that it spends much time and money dealing with as people age. We know that now, and we can do something about it.

The well-written book pulls together research from multiple disciplines. It enumerates many causes of stress, along with the consequences and mechanisms that connect them. And it offers some ways to prevent or heal the damage.

There are many sources of stress: lack of human attention, hunger, physical pain. Acute or prolonged stress can cause physiological changes that continue to cause harm over the years.

Studies link early-childhood stress and trauma to a long list of health problems, some of which don’t show up until well into adulthood: heart disease, diabetes, allergies, anxiety disorders, substance abuse. And we know now that some problems begin before birth, when, for instance, parental stress or substance abuse affects fetal development.

Damage is not limited to what happens at home.

Medical care that is supposed to help can hurt. Did you know that until the late 1980s doctors routinely operated on newborns without anesthesia because they believed the babies couldn’t feel pain? It turns out they do feel.

Many systems are implicated. Poor-quality child care can cause trauma. And even in the best case, babies need six months to form a solid attachment with their primary caregiver before being able to tolerate separation without harm. Family-leave policies have a part to play in our health.

Wiley is a 1962 graduate of Tacoma’s Lincoln High School who started learning about early childhood when she worked on revamping services for children and families in Oregon in the late 1980s and early 1990s as chief of staff for the Oregon speaker of the House.

That’s how she met Karr-Morse, now a family therapist in Portland, and former director of parent training for Oregon’s child-welfare system.

When I spoke with Wiley last week, she said they couldn’t find a book with all the information they needed, so they wrote it themselves, and they’ve done it again.

Their first book, published in 1997, “Ghosts From the Nursery: Tracing the Roots of Violence,” was based on brain-development research making news in the 1990s and focused on preventing abuse and neglect.

Wiley, who spoke at Seattle Children’s hospital last week, is now a lawyer and the New York state director of Fight Crime: Invest in Kids, an organization of law-enforcement officials who have taken to heart hard evidence that improving early life for children is the best way to prevent crime.

Now we know that we can help people live longer and healthier lives, too.

If we want better students, less crime, healthier bodies and lower medical costs, we need to protect and nurture children’s developing minds and bodies from the very start, as they are being formed.

Every year there is more evidence of the effectiveness of home-visitation programs, such as the Nurse-Family Partnership, in which nurses work with parents during pregnancy and after to ensure the best outcomes for children.

It’s cheaper to steer kids away from crime than to lock them up after the damage has been done. Wiley said New York spends about $266,000 a year to keep a kid in juvenile detention but only $4,800 to $5,600 per family for home-visitation programs early in a child’s life.

Evidence-based home-visitation programs serve about 6,000 families in Washington, Wiley said, or about 15 percent of the families that need the service.

Health and behavior problems get harder and more expensive to solve as people age. I agree with Wiley that especially in a poor economy, we should use our money where it will do the most good. And now, we know where that is.